吕海江从郁论治前部缺血性视神经病变  

Professor LYU Haijiang Treating Anterior Ischemic Optic Neuropathy from Perspective of Qi Stagnation

作　　者：马宏杰 冯磊[2] 吕海江[2] 周尚坤 娄艳蕊 MA Hongie;FENG Lei;LYU Haijiang;ZHOU Shangkun;LOU Yanrui(Zhengzhou Boai Eye Ear Nose and Throat Hospital,Zhengzhou Henan China 450004;The Third Affliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008;Wang Jing Hospital Affliated to Chinese Academy of Chinese Medicine,Beijing China 100102)

机构地区：[1]郑州博爱眼耳鼻喉医院,河南郑州450004 [2]河南中医药大学第三附属医院,河南郑州450008 [3]中国中医科学院望京医院,北京100102

出　　处：《中医学报》2021年第2期333-336,共4页Acta Chinese Medicine

基　　金：吕海江全国名老中医药专家传承工作室建设项目{国中医药人教涵[2018]134号}。

摘　　要：前部缺血性视神经病变(anterior ischemic opticneuropathy,AION)病位在目系,与心、肝、肾关系密切。在治疗上可分期辨证论治:AION急性期,以目系脉络郁阻、神光受抑为主要病机,应以开郁导滞、通窍明目为主,同时酌情施以清热化痰、利湿消肿、清肝泻火、滋阴降火、平肝潜阳及理气健脾等治法,方药常选用张望之教授《眼科探骊》中内障病主方加减;AION萎缩期,以脉络闭阻、目系萎缩、神光衰微为主要病机,应以开郁导滞、补肾明目为主,方药常选用内障病主方合驻景丸加减。吕教授还注重应用虫类药物如水蛭、全蝎、蜈蚣、地龙等以增强通络开窍之力。Anterior ischemic optic neuropathy(AION)is located in the eyes and is closely related to the Heart,Liver and Kidney.Treatment can be divided into different stages:In the acute stage of AION,the main pathogenesis is the depression of the target system and the suppression of the light.The main pathologies should be to relieve the stagnation and lead the stagnation,to relieve the orifice and to improve the eyes.At the same time,the methods should be used appropriately like clearing Heat,reducing Phlegm,relieving Dampness and swelling as well as clear Liver Fire,nourishing Yin to reduce Fire,calming Liver and suppressing Yang,regulating Qi and invigorating Spleen,etc.The prescriptions used are modified prescriptions made by Professor Zhang Wangzhi in Yan Ke Tan Li;In the atrophy stage of AION,the main pathogenesis is the obstruction of the choroid,the atrophy of the eye system,and the decline of the light.The main pathologies should be to relieve the Qi stagnation,nourish Kidney and improve the eyesight.Professor LYU also pays attention to the application of insect medicines such as Shuizhi(Leeches),Quanxie(Scorpions),Wugong(Centipedes)and Dilong(Earthworms)to enhance the ability of collaterals and resuscitation.

关 键 词：前部缺血性视神经病变 从郁论治 内障病方 驻景丸 张望之 吕海江 

分 类 号：R276.7[医药卫生—中医五官科学]